Impaired colour discrimination in Huntington's disease

Colour discrimination and visual contrast perception were investigated in 18 patients with Huntington's disease (HD) and in 18 age- and sex-matched healthy volunteers using the Farnsworth-Munsell 100 Hue test (FM) and stationary contrast targets. The mean total error score (MTES) and the partial scores for the “red-green” and the “blue-yellow” axes in the FM of the patients with HD were significantly elevated as compared to controls (MTES in HD: 113.0 ± 90.8; MTES in controls: 19.2 ± 8.8). The spatial contrast sensitivity in HD patients was normal. The colour perception dysfunction indicates that the visual system is affected in HD. The visual disorder may be related to an imbalance of certain neurotransmitters in the visual system of HD patients. Possible anatomical sites of the dysfunction responsible for colour discrimination abnormalities could be the retinal cone system and/or impaired parvocellular central visual pathways in HD.     

Rehabilitationsmanagement

Trauma und Berufskrankheit - Die Berufsgenossenschaft der chemischen Industrie hat eine Fall-Kontroll-Studie durchgeführt, um Effekte einer Interventionsstrategie des Sachbearbeiters zusammen...     

Influence of hospital characteristics on operative death and survival of patients after major cancer surgery in Ontario.

BACKGROUND: There is a lack of information from Canadian hospitals on the role of hospital characteristics such as procedure volume and teaching status on the survival of patients who undergo major cancer resection. Therefore, we chose to study these relationships using data from patients treated in Ontario hospitals. METHODS: We used the Ontario Cancer Registry from calendar years 1990-2000 to obtain data on patients who underwent surgery for breast, colon, lung or esophageal cancer or who underwent major liver surgery related to a cancer diagnosis between 1990 and 1995 in order to assess the influence of volume of procedures and teaching status of hospitals on in-hospital death rate and long-term survival. For each disease site and before observing patient outcomes data, volume cut-off points were selected to create volume groups with similar numbers of patients. Teaching hospitals were those directly affiliated with a medical school. Logistic regression and proportional hazards models were used to consider the clustering of data at the hospital level and to assess operative death and long-term survival. We also used 4 measures to gauge the degree of procedure regionalization across the province including (1) the number of hospitals performing a procedure; (2) the percentage of patients treated in teaching hospitals; (3) the percentage of rural patients treated in higher volume procedure hospitals; and (4) median distances travelled by patients to receive care. RESULTS: The number of patients in our cohorts who underwent resection of the breast, colon, lung, esophagus or liver was 14 346, 8398, 2698, 629 and 362, respectively. Surgery in a high-volume versus a low-volume hospital did not have a statistically significant influence on the odds of operative death for patients who underwent colon, liver, lung or esophageal cancer resection. The risk of long-term death was increased in low-volume versus high-volume hospitals for patients who underwent resection of the breast (hazard ratio [HR] 1.2, 95% confidence interval [95% CI] 1.0-1.4, p < 0.05), lung (HR 1.3, 95% CI 1.1-1.6, p < 0.01) and liver (HR 1.7, 95% CI 1.0-2.7, p = 0.04). There were no significant differences in the odds of operative (in-hospital) death or risk of long-term death among patients treated in teaching compared with nonteaching hospitals. There was more regionalization of liver, lung and esophageal operations versus breast and colon operations. CONCLUSIONS: Increased hospital procedure volume correlated with improved longterm survival for patients in Ontario who underwent some, but not all, cancer resections, whereas hospital teaching status had no significant impact on patient outcomes. Across the province, further regionalization of care may help improve the quality of some cancer procedures.     

Ein Kritischer Beitrag zur Indikationsstellung und Begrenzung Psychotherappeutischer Massnahmen des Gynäkologen

Ohne ZusammenfassungNach einem Vortrag in der Medizinischen Gesellschaft in Gießen, Sitzung vom 6. Juli 1926.     

Bilaterale rezidivierende retinale Thrombose bei einem jungen Mann

A 41-year-old male patient presented with veiled vision which had appeared only a few hours previously. Funduscopy revealed a retinal edema due to venous stasis retinopathy. A previous history was unknown except for an uncorrected arterial hypertension. A retinal vein thrombosis and macula edema developed in the affected eye. An antiphospholipid antibody syndrome was diagnosed which was treated with anticoagulants.     

An autopsy case of sudden death in a patient with sickle cell disease

An autopsy finding of sudden death due to disseminated intra-vascular sickling of RBCs in a young adult male from Madhya Pradesh while undergoing army recruitment rally, is reported because of its rarity in this part of the country.     

Der modifizierte erweiterte distal gestielte sapheno-fasziokutane Suralislappen

Zusammenfassung Nach Verifikation der anatomischen Voraussetzungen wurde eine modifizierte Technik des erweiterten saphenofasziokutanen Suralislappen für große kombinierte Knochen-Weichteil-Infekt-Defekt-Situationen sogenannte Typ-C-Läsionen bei Risikopatienten mit ersatzschwachem bzw. ersatzunfähigem Lager (traumatische ipsilaterale arterielle Hauptgefäßläsion, tiefe ipsilaterale Venenthrombose, diabetische Polyneuropathie mit Mikroangiopathie bzw. PAVK Stadium 3) in einer prospektiven Studie angewendet. Zehn Weichteildefekte zwischen 80–180 cm² im Mittel-Rückfuß- bzw. distalen Unterschenkelbereich wurden einzeitig komplett mit einem retrograd gestielten modifizierten saphenofasziokutanen Suralislappen aus dem proximalen Unterschenkel gedeckt. Alle Lappen heilten ohne Lappennekrosen ein. Die Entnahmestellen wurden siebenmal mittels primärer Naht und dreimal einzeitig mit Meshgraft verschlossen. Bei der Nachuntersuchung aller Patienten nach im Mittel 22 Monaten bestanden vitale Lappen, keine Hebedefektmorbidität, kein Suralisneurom und es war kein sekundäres Debulking oder andere lappeninduzierte Revisionen erforderlich.